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CITY OF CRYSTAL LAKE NPI 1366469215


NPI Information

NPI: 1366469215
Provider Name: CITY OF CRYSTAL LAKE

Former Legal Business Name: CRYSTAL LAKE EMERGENCY

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
100 W WOODSTOCK ST
CRYSTAL LAKE, IL
ZIP 60014
Phone: (815) 459-2020
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CITY OF CRYSTAL LAKE is a land transport ambulance in Crystal Lake, IL. CITY OF CRYSTAL LAKE NPI is 1366469215. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Crystal Lake Emergency.

The provider's business location address is:

100 W WOODSTOCK ST
CRYSTAL LAKE, IL
ZIP 60014-262
Phone: (815) 459-2020
Fax: (815) 477-2568

The provider's authorized official is James Moore .
The authorized official title is Fire Chief and has the following contact phone number (815) 459-2020.

The enumeration date for this NPI number is 7/16/2006 and was last updated on 8/1/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13416L0300XAmbulanceLand Transport7140ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========OTHERILLINOISTRICARE NORTH
2250800MEDICARE PINILLINOIS
30004531041OTHERILLINOISAETNA
4590028206MEDICARE PINILLINOIS
5=========MEDICARE PINILLINOIS
6590028206OTHERILLINOISRR MEDICARE
75670002OTHERILLINOISBCBS
8=========001MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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